| NPI | 1215740980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA066387) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA007171) |
| 363A00000X Physician Assistant (Licence: PA MP9448627) | |
| Enumeration Date | 2025-01-28 |
| Last Update Date | 2025-03-31 |